************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************ 1. PLACE OF DEATH County: BRECKINRIDGE Vot. Pol.: BALLTOWN Inc Town: City: No. St. Ward: Registration District No.: 5321 Primary Registration District No: File No. 22933 Registered No: 10 2. FULL NAME: BOLLING, ERNEST PERSONAL AND STATICAL PARTICULARS 3. SEX: MALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: SINGLE 6. DATE OF BIRTH: DEC 30, 1906 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 8 / illeg / 18 8. OCCUPATION (a.) Trade, profession or particular kind of work: (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: KENTUCKY 10. NAME OF FATHER: ALLISON BOLLING 11. BIRTHPLACE OF FATHER: KENTUCKY 12. MAIDEN NAME OF MOTHER: MELINDA HARRIS 13. BIRTHPLACE OF MOTHER: KENTUCKY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) WILLIAM SANDERS (Address) BRECKINRIDGE 15. Filed SEP 18, 1914 REGISTAR: FRED FRANK MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: SEP 18, 1914 17. I HEREBY CERTIFY, That I attended deceased from (date): SEP 16, 1914 to SEP 18, 1914 That I last saw him/her alive on (date): SEP 16, 1914 And that death occurred on the date stated above at (time AM/PM): 2 PM THE CAUSE OF DEATH was as follows: TYPHOID FEVER (Duration) Years: Months: Days: 21 Contributory: TYPHOID FEVER (Duration) Years: Months: Days: Signed (M.D.): T.L. LIGHTFOOT Date: SEP 18, 1914 Address: CLOVERPORT 18. LENGTH OF RESIDENCE (For Hospitals, Institutions, Transients, or Recent Residents) At place of death (yr, mo, da.): In the State (yr, mo, da): Where was disease contracted, if not at place of death? Former or usual residence: 19. PLACE OF BURIAL OR REMOVAL: HANCOCK COUNTY, KY DATE OF BURIAL: SEP 19, 1914 20. UNDERTAKER: M. HAMMONS & SON ADDRESS: CLOVERPORT ADDITIONAL COMMENTS/NOTES: ************************************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************